Insidens Defisiensi Besi dan Anemia Defisiensi Besi pada Bayi Berusia 0-12 Bulan di Banjarbaru Kalimantan Selatan: studi kohort prospektif

Harapan Parlindungan Ringoringo

Sari


Latar belakang. Anemia defisiensi besi (ADB) merupakan salah satu masalah kesehatan gizi di Indonesia. Survei kesehatan rumah tangga (SKRT) tahun 2001 menunjukkan prevalensi ADB pada bayi kurang dari 1 tahun 55%.
Tujuan. Mengetahui insidens deplesi besi, defisiensi besi, dan anemia defisiensi besi pada bayi berusia kurang dari 1 tahun.
Metode. Desain penelitian adalah studi kohort prospektif dengan pembanding eksternal. Dijumpai 211 bayi ikut dalam penelitian, terdiri dari 143 bayi lahir dari ibu tanpa anemia dan 68 bayi lahir dari ibu dengan anemia. Pemeriksaan darah tepi lengkap, gambaran darah tepi, feritin, saturasi transferin (ST) dilakukan saat bayi berusia 0, 1, 2, 3, 4, 5, 6, dan 12 bulan. Diagnosis ADB berdasarkan 1) kadar hemoglobin <14g/dL untuk usia 0-3 hari, <11g/dL usia 1 bulan, <10g/dL usia 2-6 bulan, <11g/dL usia 6-12 bulan, 2) mikrositik dan atau hipokrom, 3) kadar hemoglobin meningkat setelah diberi terapi besi, 4) feritin <12 ug/L usia 6-12 bulan, 5) RDW >14%, 6) Indeks Mentzer >13; 7) Indeks RDW >220. Deplesi besi bila ST <30% untuk usia 0-1 bulan, ST <21% untuk usia 2-6 bulan, feritin<20 ug/L usia 6-12 bulan. Defisiensi besi bila ST <20% usia 0-1 bulan, ST <16% usia 2-6 bulan, feritin <12 ug/L usia 6-12 bulan.
Hasil. Insidens deplesi besi, defisiensi besi, ADB berturut-turut 11,4%, 7,6%, 47,4%, tertinggi pada bayi berusia 0 bulan, yaitu berturut-turut 9,5%, 14,2%, 11,8%.
Kesimpulan. Insidens deplesi besi, defisiensi besi, ADB paling tinggi dijumpai pada bayi berusia 0 bulan.


Kata Kunci


deplesi besi; defisiensi besi; ADB; bayi

Teks Lengkap:

PDF

Referensi


Schneider JM, Fujii ML, Lamp CL, Lonnerdal B, Dewey KG, Zidenberg-Cherr S. Anemia, iron deficiency, and iron deficiency anemia in 12-36-mo-old children from low-income families. Am J Clin Nutr 2005;82:1269-75.

Helen Keller International (Indonesia). Iron deficiency anemia in Indonesia. Report of the policy workshop on iron deficiency anemia in Indonesia. Jakarta: 1997.h.1-16.

Lozoff B. Iron deficiency in infancy: applying a physiologic framework for prediction. Am J Clin Nutr 2006;84:1412-21.

Untoro R, Falah TS, Atmarita, Sukarno R, Kemalawati R, Siswono. Anemia gizi besi. Dalam: Untoro R, Falah TS, Atmarita, Sukarno R, Kemalawati R, Siswono, penyusun. Gizi dalam angka sampai dengan tahun 2003. Jakarta: DEPKES; 2005.h.41-4.

Pee S, Bloem MW, Sari M, Kiess L, Yip R, Kosen S. The high prevalence of low hemoglobin concentration among Indonesian infants aged 3-5 months is related to maternal anemia. J Nutr 2002;132:2215-21.

Lozoff B, Andraca I, Castilo M, Smith BS, Walter T, Pino P. Behavioral and development effects of preventing iron-deficiency anemia in healthy full-term infants. Pediatrics 2003;112:846-54.

Halterman JS, Kaczorowski JM, Aligne A, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United states. Pediatrics 2001;107:1381-6.

Algarin C, Peirano P, Garrido M, Pizarro F, Lozoff B. Iron deficiency anemia in infancy: long-lasting effects on auditory and visual system functioning. Pediatr Res 2003;53:217-23. 9. Lundstorm UL, Siimes MA, Dallman PR. At what age does iron supplementation become necessary in low-birth-weight infants? J Pediatr 1977;91:878-83.

Rios E, Lipschitz DA, Cook JD, Smith NJ. Relationship of maternal and infant iron stores as assessed by determination of plasma feritin. Pediatrics 1975;55: 694-9.

Saarinen UM, Siimes MA. Developmental changes in serum iron, total iron-binding capacity, and transfering saturation in infancy. J Pediatr 1977;91:875-7.

Ziaei S, Hatefnia E, Togeh Gh. Iron status in newborns born to iron-deficient mothers. Iran J Med Sci 2002; 28:62-4.

Kilbride J, Baker TG, Parapia LA, Khoury SA, Shuqaidef, Jerwood D. Anaemia during pregnancy as a risk factor for iron-deficiency anaemia in infancy: a case-control study in Jordan. Int J Epid 1999;28:461-8.

Erhardt JG, Estes JE, Pfeiffer CM, Biesalski HK, Craft NE. Combined measurement of ferritin, soluble transferrin receptor, retinol binding protein, and C-reactive protein by an inexpensive, sensitive, and simple sandwich enzyme-linked immunosorbent assay technique. J Nutr 2004;134:3127-32.

Dallman PR. Iron deficiency anemia: a synthesis of current scientific knowledge and U.S. recommendations for prevention and treatment. Dalam: Earl R, Woteki CE, penyunting. Iron deficiency anemia: recommended guidelines for prevention, detection, and management among U.S children and women of childbearing age. Didapat dari: http://www.nap.edu/catalog/2251.html.

Andrews NC. Iron deficiency and related disorders. Dalam: Greer JP, Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B, penyunting. Wintrobe’s Clinical Hematology. Edisi kesebelas, vol 1. Philadelphia: Lippincott William & Wilkins; 2004.h.979-1009.

Glader B. Anemia: general considerations. Dalam: Greer JP, Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B, penyunting. Wintrobe’s clinical hematology. Edisi kesebelas, vol 1. Philadelphia:Lippincott William & Wilkins; 2004.h.947-78.

Smith H. Normal values and appearance. Dalam: Smith H, penyunting. Diagnosis in paediatric haematology. New York:Churchill Livingstone; 1996.h.1-33.

Yip R, Walsh KM, Goldfarb MG, Binkin MJ. Declining prevalence of anaemia in childhood in a middle-class setting: a paediatric success story? Pediatrics 1987;80:330-4.

Ervasti M, Kotisaari S, Senkilampi U, Heinonen S, Punnonen K. The relationship between red blood cell and reticulocyte indices and serum markers of iron status in the cord blood of newborns. Clin Chem Lab Med 2007;45:1000-3.

Siegel EH, Stoltzfus RJ, Khatry SK, LeClerq S, Katz J, Tielsch JM. Epidemiology of anemia among 4-to 17-month children living in South Central Nepal. Eur J Clin Nutr 2006;60:228-35.

Sekartini R, Soedjatmiko, Wawolumaya C, Yuniar I, Dewi R, Nycane. Prevalensi anemia defisiensi besi pada bayi usia 4-12 bulan di Kecamatan Matraman dan sekitarnya, Jakarta Timur. Sari Pediatri 2005;7:2-8.

Ringoringo HP, Windiastuti E. Profil parameter hematologik dan anemia defisiensi zat besi bayi berumur 0-6 bulan di RSUD Banjarbaru. Sari Pediatri 2006;7:214-8.

Meinzen-Derr JK, Guerrero ML, Altaye M, Ortega-Gallegos H, Ruiz-Palacios GM, Morrow AL. Risk of Infant Anemia Is Associated with exclusive breast-feeding and maternal anemia in a Mexican Cohort. J. Nutr 2006;136:452-8.

Agarwal RMD, Tripathi AM, Agarwal KN: Cord blood hemoglobin, iron and ferritin status in maternal anemia. Acta Paediatr Scand 1983;72:545-8.

Erdem A, Erdem M, Arslan M, Yazici G, Eskandari R, Himmetoglu O: The effect of maternal anemia and iron deficiency on fetal erythropoiesis: comparison between serum erythropoietin, hemoglobin and ferritin levels in mothers and newborns. J Matern Fetal Neonatal Med 2002;11:329-32.

Kelly AM, MacDonald DJ, Mc Dougall AN: Observations on maternal and fetal ferritin concentrations at term. Br J Obstet Gynaecol 1978;85:338-43.

Fenton V, Cavill I, Fisher J: Iron stores in pregnancy. Br J Haematol 1977;37:145-9.




DOI: http://dx.doi.org/10.14238/sp11.1.2009.8-14

Refbacks

  • Saat ini tidak ada refbacks.


##submission.copyrightStatement##

##submission.license.cc.by-nc-sa4.footer##

Informasi Editorial:
Badan Penerbit Ikatan Dokter Anak Indonesia
Jl. Salemba I No 5, Jakarta 10430, Indonesia
Phone/Fax: +62-21-3912577
Email: editorial [at] saripediatri.org

Lisensi Creative Commons
Sari Pediatri diterbitkan oleh Badan Penerbit Ikatan Dokter Anak Indonesia
Ciptaan disebarluaskan di bawah Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.